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45-Year-Old Male with Lesions on Superior Gluteal Cleft

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

A 46-year-old male presented for evaluation of lesions on the superior gluteal cleft that he could palpate but were asymptomatic. He was otherwise healthy and there was no exposure history or history of trauma.

How would you diagnose this patient?

Choose one to reveal diagnosis and discussion

Herpes simplex
Human papillomavirus
Lichen planus
Psoriasis
Porokeratosis

Answer: Porokeratosis

See the full case at Consultant360

A biopsy revealed the rare variant of porokeratosis ptychotropica. As of 2014, there were less than 25 reports in the literature. A biopsy will confirm the diagnosis. Multiple lesions can be removed by liquid nitrogen or via a shave biopsy as they typically do not respond to topical medications.

Reference:

D’souza P, Dhali TK, Arora S, et al. Porokeratosis ptychotropica: a rare variant of porokeratosis. Dermatol Online J. 2014;20(6)